Jeffrey S Wisch, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

45726 Issued in MA

Practice address

2014 Washington St
Vernon Cancer Center
Newton, MA 02462-1607

Phone

(617) 658-6000

Fax

(617) 658-6001

NPI assigned

Mar 1, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New England Radiation Oncology Associates PC

  • Radiation Oncology Physician
  • Newton, MA
  • NPI 1255560207
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254700800000",
    "number": "1871560664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "address_2": "VERNON CANCER CENTER",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621607",
            "telephone_number": "617-658-6000",
            "fax_number": "617-658-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "address_2": "VERNON CANCER CENTER",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621607",
            "telephone_number": "617-658-6000",
            "fax_number": "617-658-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISCH",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2009-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "45726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0162973",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Magdalena Wilson
• William Fryer Winchell, MD
• Julie Melissa Winsett, MD
• Aiden Winslow, LMHC
• Christina Winsor
• London Wise
• Susana C Wishnia, M.D.
• Chandra Elizabeth Wisneski, DC, ATC
• Gabrielle Witham
• Carol A Wogrin, PSY.D.

• Specialist in Newton, MA
• Providers in Newton, MA by specialty
• Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.